The California Department of Industrial Relations, Division of Workers’ Compensation (DWC) is on track to meet its Nov. 1 deadline for adopting emergency regulations that will allow medical provider networks to begin operating in California. Medical provider networks (MPNs), which may be established by employers or insurers on or after Jan. 1, 2005, will provide care to workers injured on the job.
“Medical provider networks must be approved by the DWC before they can be used, and these new regulations streamline the approval process,” said DWC Administrative Director Andrea Hoch. “We want the networks ready so injured workers can get the treatment they need and return to work.”
Medical provider networks ensure workers in need of medical treatment receive proper care in an expedited manner and must meet certain standards. Those standards include improved access to care for common occupational injuries and illnesses, continuity of care, medical decision making, and following treatment guidelines. Medical provider networks must also allow employees a choice of provider in the network (after the first visit) and a way to get second and third opinions. If an employer or insurer uses an approved MPN, covered employees will receive their medical care from a provider within the network, unless a pre-designated physician is chosen prior to an injury.
“These regulations are the first created to implement Senate Bill 899 –workers’ compensation legislation signed by the governor in April,” Hoch said. “And they reflect the spirit and letter of the law.”
The regulations were drafted by the division in collaboration with a diverse advisory group that includes employer, labor, medical provider and insurer representatives, and which is meeting Sept. 14 to review the draft rules. The valuable input provided by the advisory group prior to adoption of the emergency regulations establishes a firm foundation for the adoption of permanent regulations.
The DWC will review comments from the meeting and post the proposed regulations on its Web site by the end of the week. Members of the public may comment on the regulations on line prior to their adoption as emergency regulations Nov. 1 by going to the DWC Web site at http://www.dir.ca.gov/WCJudicial.htm and clicking on current forums.
Once the Office of Administrative Law approves the emergency regulations, the DWC will have 120 days to adopt permanent regulations, a process that includes formal public hearings.
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